Health-care reform through green-colored glasses

With a summer of incendiary rhetoric and fabricated charges by the right-wing dominating the media headlines, President Obama took to the bully pulpit to sell his plan for what is now being called “Health Insurance Reform” rather than health care reform.

President Obama and congressional leaders have made health-care reform and tackling global warming their top priorities this year, yet little to no analysis has been made on what a climate policy that shuts down carbon-spewing smokestacks and tailpipes would mean to the health-care sector. Yet, the health impacts of climate legislation are likely to be enormous, one of the largest and most radical efforts ever at preventative care, by eliminating the sources of the pollutants that make us sick.

Climate legislation could save Americans more money and avoid more crippling health conditions than the other leading progressive policy solution: a public option.

The sources of carbon emissions are also the sources of other environmental pollutants that cause high rates of cancer and respiratory and neurological disease. A properly designed climate policy could save the health sector hundreds of billions of dollars, save businesses billions by avoiding lost workdays and rising health-care premiums, and reduce government costs for providing health care to the most vulnerable groups, children and the elderly.

Research in this field is devilishly difficult to come by, despite the plethora of research into the possible health impacts of climate change and a solid body of research on air and water pollution and environmental health. Studies on the health impacts of climate policy are mostly the province of European agencies providing health care and administering climate policy. In its 2008 report, the European Environment Agency put health care savings for the EU’s new 20 percent reduction in carbon emissions 2020 target in the range of $44 billion dollars annually.

Last night Obama noted that “We spend one and a half times more per person on health care than any other country, but we aren’t any healthier for it.” Even with its smaller population, if you factor in the higher health costs in the United States and the looser environmental regulations, you can calculate a back of the envelope estimate of possible health care savings. Over ten years, we could save in the range of $450 billion dollars, a figure greater even than the savings from a public option, which has been estimated at $226 to $400 billion by the Urban Institute.

While a debate rages about how to enact health care reform, most efforts are focused on reducing the cost of providing health services to the population. A public insurance option to compete with private insurers, government negotiation with drugmakers for lower costs, the digitization of records, and mandates for insurance are all seen as solutions to reduce the cost of health care. The only major part of the health care debate focused on eliminating the need for health care services involves confronting the national obesity crisis, which is increasingly seen as linked to commuter culture and the availability of industrial food.

In his speech, President Obama embraced the importance of preventative care, because “it saves money, and it saves lives.” That same logic applies to cleaning up the health impacts of fossil fuels.

And yet, the millions of cases of asthma, heart disease, and that could be linked to the soot, ozone, toxic chemicals and heavy metals originating from the burning and refining of fossil fuels are seen as an unchanging part of any business-as-usual model for future health care costs.

Environmental advocates and congressional leaders have a different future in mind for the use of fossil fuels, calling for regulation to dramatically increase the nation’s use of renewable energy and increasing energy efficiency. Recently, the House of Representatives passed the Waxman-Markey bill, a sprawling 1,400 page effort to regulate carbon emissions from the nation’s transportation fleet and energy sector.

Environmental justice advocate Majora Carter said this spring, “Our energy policy in the United States is subsidized by the health of poor people.” Asthma, heart disease, and other life-threatening illnesses exacerbated by air pollution kill thousands and send millions of worried parents to emergency rooms every year with children struggling to breathe. Governments are forced to pick up the check when uninsured patients seek emergency care or catastrophic health care costs force bankruptcy.

Dirty energy facilities are often sited in poor communities, which have the highest rates of being uninsured and indigent. The high cost of treating respiratory and heart disease in an emergency room is passed on to the government and the ratepayers.

Obama clearly understands how this, saying “Those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for somebody else’s emergency room and charitable care”

Environmental injustice is not just a moral or social issue. It’s also a fiscal issue. Cleaning up pollution hotspots could reduce healthcare costs to government and those with health insurance by $450 billion. I think this bears repeating; environmental justice advocates have a legitimate, fiscally conservative argument that cleaning up their communities saves the country and Obama’s health care plan money.

If you are making a moral argument, as Obama did when he invoked the memory of the late Sen. Ted Kennedy, the savings in lives and misery from preventing the need for healthcare, versus making that care more accessible and affordable is stronger than it has ever been. It is more ethical to prevent someone from getting lung cancer, than simply make the care for their cancer more affordable. I want to be clear though, this isn’t an either/or case, rather an example of how progressive climate and health legislation can work together to avoid misery and save the country money.